SPEAK OUT! vs. LSVT LOUD: Why I Chose SPEAK OUT!
When working with patients who have Parkinson’s disease (PD) and other neurological conditions, one of the most common challenges they face is the decline of their voice. Speech therapy plays a crucial role in helping them maintain communication and improve their quality of life. Two of the most well-known, evidence-based treatment programs for voice disorders in PD are SPEAK OUT! and LSVT LOUD. Both approaches are effective, but they take slightly different paths to achieve their goals.
After researching and considering both options, I chose to pursue SPEAK OUT! for my practice. This decision wasn’t because one program is necessarily better than the other—both have strong research backing their effectiveness. Instead, I chose SPEAK OUT! based on what I felt would best serve the needs of my patients.
SPEAK OUT! vs. LSVT LOUD: A Comparison
LSVT LOUD: A Focus on Loudness
LSVT LOUD (Lee Silverman Voice Treatment) is a well-established, high-intensity therapy program designed to help individuals with PD increase their vocal loudness. It follows a structured four-week protocol, with four sessions per week and daily home exercises. The program emphasizes recalibrating the patient’s perception of their voice, as many individuals with PD feel they are speaking at a normal volume when, in reality, their voice has become much softer.
LSVT LOUD has been widely researched and is highly effective for improving vocal intensity. However, its intensity and structured approach may not be ideal for every patient—especially those with cognitive challenges or difficulty committing to a rigorous daily practice routine.
SPEAK OUT!: Speaking with Intent
SPEAK OUT! was developed by the Parkinson Voice Project and takes a slightly different approach. Instead of focusing solely on increasing loudness, it emphasizes “Speaking with Intent”, engaging the brain in a way that helps individuals produce clearer and more deliberate speech. This method integrates both speech and cognitive exercises, making it especially beneficial for patients who experience cognitive changes alongside their speech difficulties.
The SPEAK OUT! program typically consists of 12 sessions over four weeks, followed by ongoing group therapy through LOUD Crowd, which provides long-term support and maintenance.
Key Differences at a Glance
Feature SPEAK OUT! LSVT LOUD
Core Focus Speaking with Intent Increasing Loudness
Structure 12 sessions over 4 weeks 16 sessions over 4 weeks
Cognitive Integration Yes, integrates speech & cognition No direct cognitive component
Flexibility More adaptable for different patients Strict, high-intensity protocol
Maintenance LOUD Crowd group therapy Daily exercises & periodic follow-ups
Why I Chose SPEAK OUT!
As a speech therapist, I always strive to choose interventions that best fit the needs of my patients. Here’s why SPEAK OUT! stood out to me:
1. It’s More Flexible – While LSVT LOUD has a strict protocol, SPEAK OUT! offers more adaptability, making it easier to tailor to individual patient needs.
2. It Integrates Cognitive Exercises – Many of my patients experience cognitive changes, and I appreciate that SPEAK OUT! incorporates strategies that engage both the mind and voice.
3. It Offers Long-Term Support – The LOUD Crowd provides an opportunity for patients to stay engaged in therapy beyond their initial treatment, offering a sense of community and accountability.
4. It’s Easier for Some Patients to Maintain – The slightly less intense structure may be more manageable for individuals who struggle with fatigue, cognitive decline, or a demanding therapy schedule.
Final Thoughts
Both SPEAK OUT! and LSVT LOUD are excellent, research-supported treatment options for individuals with Parkinson’s disease and other voice disorders. My decision to choose SPEAK OUT! was based on what I felt would best meet the needs of my patient population, not because one approach is superior to the other. LSVT LOUD is a fantastic program for those who can commit to its rigorous structure and benefit from an emphasis on loudness. Meanwhile, SPEAK OUT! offers a more flexible, cognitive-integrated approach that can be a better fit for some individuals.
